Insufficiencies of the oblique muscles and how to correct them / by G.C. Savage.

  • Savage, G. C. (Giles Christopher), 1854-1930.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Insufficiencies of the oblique muscles and how to correct them / by G.C. Savage. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Reminding him that I had twice investigated his eyes and each time had found the same conditions and had corrected all that was correctable, I told him I was willing to try again, but that I was now as unable to correct the insufficiency of his obliques as I ever was. In the course of this conversation I told him if he had but one eye he would not be a sufferer. Deciding that it would be four days before he could return for another ex- amination he went away. On the 17th at the hour appointed he came; and without hope of finding an additional means of relief, I under-took the investigation again. The results of former examinations a3 to lenses were confirmed. My study of the recti muscles resulted as formerly in finding a left hyperphoria of J°. With the remark “ we will now look into that incorrcctable condition,” I began to investigate the obliques. Placing the 6° double prism before his right eye, the left eye (the one under test) showed the middle line dipping unmistakably to the right, as in Fig. 1, thus showing insufficiency of the left superior oblique. Transferring the double prism to the left eye, the right eye showed the middle line dipping to the left, as in Fig. 3, thus showing insufficiency of the right superior oblique. Having stated again that nothing more could be done for him, in a moment the thought occurred to me that, if a cylinder was placed before the eye in such a way as to make the line incline still more in the same direction, on removing the double prism the weak obliques would have to act more than usual in binocular vision. I reasoned that this over-action being in the nature of gymnastic exercise, if conducted properly must develop the weak muscles, and thus be a source of relief to the patient. Leaving the double prism in front of the right eye I placed a -f- 2.00 cylinder before his left and revolving it so as to bring its axis to 135° the middle line was seen to dip very much more to the right. I then turned the axis back to 90° when the dipping was the same as when no cylinder was on. Turning the axis of this cylinder to 45° the middle line was made parallel with the other two (this little proceedure of plac- ing the axis of a cylinder obliquely first in one direction then in the other, and watching the effect on the middle line will estab- lish or disprove the correctness of the diagnosis). The diagnosis